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Studies of relatively recently resettled refugees have noted social disconnection, linked to various physical and mental health outcomes, as a concern. Limited studies have examined whether social disconnection and its effects persists within refugee populations resettled more than 3 decades prior. The relationship between social disconnection and self-reported health was explored in a secondary analysis of a cross-sectional needs assessment survey with a snowball sample of 100 Cambodian refugees residing in Connecticut. Social disconnectedness and comorbid health conditions were prevalent. Lack of religious and community engagement were associated with poor health outcomes, while individuals with a lack of ethnic engagement reported better overall health. This study underscores the importance of understanding the specific risks that social disconnection poses to refugees who have resettled many years before and their offspring that may assist in better serving currently settling refugees within the United States.

In many jurisdictions, public safety and public health entities are working together to enhance the timeliness and accuracy of the analytical characterization and toxicology testing of novel synthetic opioids. The improved sharing and early detection of these analytical data are intended to inform surveillance, interdiction efforts, patient intervention and treatment, all of which are critical to curbing the opioid epidemic. Forensic practitioners working to identify novel synthetic opioids struggle to provide timely results when encountering new or unknown substances, such as the fentanyl analogs. These compounds, which mimic heroin in pharmacologic effect but can be far more potent, are inconsistently present in chemical identification libraries, and are currently largely unavailable as reference materials for analytical comparison. Additionally, federal, state and local governments as well as nongovernmental organizations require potency, toxicity and potential-for-abuse data to evaluate the potential health risks of emerging drug threats. Subsequent scheduling efforts and criminal prosecutions also require these thorough drug characterization studies. Pilot programs have demonstrated that early communication of real-time drug toxicity and analytical data significantly impacts the successful response to emerging opioids. High-quality, real-time, national-level data on chemical composition, toxicological test data, drug toxicity and overdoses, and analysis of seized materials by law enforcement are needed to track drug trends. However, the USA still lacks a national system to coordinate and communicate toxicology, medical and medical examiner and coroner data with the broader medical and law enforcement communities. Opportunities to address these gaps as well as recent advancements collected through interagency efforts and technical workshops in the toxicology and analytical chemistry communities are presented here. Opportunities for partnership, increased communication and expanding best practices to move toward an integrated, holistic analytical response are also explored.

Objective: Evaluate trajectories of type 1 diabetes health indicators from high school through the first year of college., Participants: Seventy-four students with type 1 diabetes who maintained pediatric endocrinology care during the first year of college., Methods: Hemoglobin A1c (HbA1c), blood glucose monitoring frequency, body mass index (BMI), and clinic attendance data were collected via retrospective medical chart review in spring 2012. Group-based trajectory models evaluated diabetes-related health indicators over time and identified distinct growth trajectory groups., Results: BMI increased and clinic attendance decreased in the first year of college. Trajectories for other health indicators were heterogeneous and stable over time; 69% of students were classified as having stable good glycemic control. Racial minority youth and youth on conventional insulin regimens were disproportionally represented in higher-risk groups., Conclusions: Diabetes health indicators are stable or decline upon college entrance. Results signal the need for targeted support for college students with type 1 diabetes.

Objectives: Mindfulness-based cognitive therapy (MBCT) is a group-based intervention similar to mindfulness-based stress reduction, but which includes cognitive therapy techniques. This study investigates its usefulness in the treatment of depressive, anxiety and stress/distress symptoms in cancer patients referred to a psycho-oncology service. It also examines whether effect on depression is mediated by self-compassion., Method: In phase 1 of this study, 16 cancer patients with mild/moderate psychological distress were randomised to MBCT (n=8) or treatment as usual (TAU; n=8), and assessed pre- and post-treatment. Analysis of variance was performed to examine the effect of treatment on anxiety and depression. In phase 2, the TAU group received the intervention, and results of pre- and post-MBCT assessments were combined with those receiving MBCT in phase 1. Finally, both groups were followed up at 3 months., Results: In phase 1, the MBCT group had a significant improvement in mindfulness and a decrease in anxiety. Statistically significant improvements in both depression and anxiety were found at 3 month follow-up. Self-compassion appeared to mediate the effect on anxiety/depression., Conclusion: This small pilot study suggests that MBCT may have a beneficial effect on psychological variables often adversely affected in cancer in a heterogeneous cancer population.

Accurate subsample displacement estimation is necessary for ultrasound elastography because of the small deformations that occur and the subsequent application of a derivative operation on local displacements. Many of the commonly used subsample estimation techniques introduce significant bias errors. This article addresses a reduced bias approach to subsample displacement estimations that consists of a two-dimensional windowed-sinc interpolation with numerical optimization. It is shown that a Welch or Lanczos window with a Nelder-Mead simplex or regular-step gradient-descent optimization is well suited for this purpose. Little improvement results from a sinc window radius greater than four data samples. The strain signal-to-noise ratio (SNR) obtained in a uniformly elastic phantom is compared with other parabolic and cosine interpolation methods; it is found that the strain SNR ratio is improved over parabolic interpolation from 11.0 to 13.6 in the axial direction and 0.7 to 1.1 in the lateral direction for an applied 1% axial deformation. The improvement was most significant for small strains and displacement tracking in the lateral direction. This approach does not rely on special properties of the image or similarity function, which is demonstrated by its effectiveness with the application of a previously described regularization technique.

Unlabelled: Globally, the health disparity of hypertension is disproportionately greater within the African American population and develops at an earlier age. Elevated and continuous interaction of biologic measures during adolescence may be precursors and indicators of risk for blood pressure changes and the subsequent development of adult essential hypertension. The purpose of this study was to describe (1) the prevalence of biologic measures of risk of hypertension, specifically family history of hypertension, prehypertension, elevated salivary cortisol, and hyperresponsive cortisol and cardiovascular reactivity, and (2) the gender difference in the prevalence of biologic risk factors of hypertension., Subjects and Method: This was an exploratory descriptive design with a nonrandom purposive sample. Participants (N = 106) were high school, African American adolescents, aged 14 to 18 years. Data, including family history of hypertension, resting blood pressure, and blood pressure and cortisol levels before and after induced physiologic stress by cold water hand immersion, were measured., Results: One hundred six African American participants (49 males and 57 females) completed the study. Data described that 71% had a positive family history of hypertension. Overall, the resting blood pressures were 120 mm Hg for systolic and 68 mm Hg for diastolic. Forty-one percent of the patients had prehypertensive blood pressures; 86% had elevated cortisol; 49% had hyperresponsive blood pressure reactivity; and 35% had cortisol hyperresponsivity. Excluding ethnicity, 65% had 3 or more biologic measures of risk of hypertension. Statistically significant gender differences included male systolic pressure and number of males with prehypertension., Conclusion: This study provides evidence of the high prevalence of multiple physiologic biologic measures of risk of hypertension factors within a vulnerable population. The continuous interaction of biologic measures over time may increase the susceptibility and risk of essential hypertension development and supports the development of appropriate physiologically based behavioral interventions.

Absolute backscatter coefficients in tissue-mimicking phantoms were experimentally determined in the 5-50 MHz frequency range using a broadband technique. A focused broadband transducer from a commercial research system, the VisualSonics Vevo 770, was used with two tissue-mimicking phantoms. The phantoms differed regarding the thin layers covering their surfaces to prevent desiccation and regarding glass bead concentrations and diameter distributions. Ultrasound scanning of these phantoms was performed through the thin layer. To avoid signal saturation, the power spectra obtained from the backscattered radio frequency signals were calibrated by using the signal from a liquid planar reflector, a water-brominated hydrocarbon interface with acoustic impedance close to that of water. Experimental values of absolute backscatter coefficients were compared with those predicted by the Faran scattering model over the frequency range 5-50 MHz. The mean percent difference and standard deviation was 54% ± 45% for the phantom with a mean glass bead diameter of 5.40 μm and was 47% ± 28% for the phantom with 5.16 μm mean diameter beads.

Objective: African-American adolescents are twice as likely to develop hypertension in early adulthood than adolescents from other racial groups. The purpose of this study was to determine the efficacy of a school-based health promotion intervention., Method: Participants were African-American adolescents aged between 14 and 17 years attending an urban high school. The 9-week intervention program focused on the participants' knowledge, diet, exercise, and blood pressure., Conclusions: The intervention program was efficacious in knowledge (p = .0001), exercise (p = .0001), as well as fruit and vegetable intake (p = .0001). Differences in systolic (p = .5548) and diastolic (p = .9719) blood pressure levels were not significant.

Unlabelled: Low birth weight (LBW) has been associated with increased blood pressure and the development of cardiovascular disease including hypertension. Elevated blood pressure, cortisol, and hyperresponsiveness during physiologic stress may function as hypertension biological markers. We examined the association of blood pressure and cortisol levels during induced physiologic stress with LBW in an African American adolescent population (n = 106)., Methods and Results: Birth weight was obtained from parents. Blood pressure and cortisol levels were measured at rest and in response to an induced physiological stressor. Compared with normal birth weight group (n = 73), the LBW group (n = 33) demonstrated elevated (+4 mm Hg) diastolic pressure (P = .002) and cortisol hyperresponsiveness (P = .05). Seventy-nine percent of LBW adolescents had elevated blood pressure and/or cardiovascular reactivity (P = .04), and 39% had elevated blood pressures., Conclusions: Low birth weight African American adolescents demonstrated physiological risk factors for hypertension, and these findings add support to the association between LBW and the development of hypertension.

Unlabelled: African American (AA) adolescents are twice as likely to develop high blood pressure in early adulthood as other groups. Continuous existence of risk factors in adolescents may be precursors to adult cardiovascular changes. The purpose of this study was to describe the prevalence of cardiovascular risk factors in a sample of AA adolescents., Method: A secondary analysis was conducted on data obtained from a sample of AA adolescents (N = 48; 32 males and 16 females) ages 14-17 years from a larger study. Factors included family history of hypertension (FHH), diet, exercise, blood pressure, and cortisol levels before and after physiologic stress., Findings: Thirty-one participants (65%) had positive FHH, 35 (73%) had three or less serving of fruits/vegetables per day, 41 (85%) reported exercising less than three times per week. Of the participants, 14 (29%) had elevated blood pressure, 30 (63%) had cardiovascular reactivity, 32 (67%) had elevated cortisol, and 23 (48%) had cortisol hyper-responsivity. Ninety-four percent had four or more risk factors and 44% had six or more., Discussion: This study demonstrates the increased prevalence of physiological and behavioral risk factors in this adolescent population.

Unlabelled: Ethnicity and family history of hypertension (FHH) have been associated with the development of hypertension. Blood pressure and cortisol reactivity during physiologic stress are hypothesized to function as biologic markers for hypertension. The purpose of this study was to explore the relationship of blood pressure and cortisol reactivity physiologic to FHH in a selected sample of African American adolescents., Methods: Demographic data and physiologic measurements were obtained from 48 African American adolescents (14-17 years). Reactivity was induced by a cold pressor test of hand immersion in cold water. chi, t tests, and multivariate repeated-measures analysis were used to determine relationships., Results: Thirty-one (65%) subjects reported an FHH. Thirty (63%) subjects demonstrated cardiovascular reactivity. Although the mean systolic blood pressure was 4 mm Hg higher, t tests indicated no significance between group in systolic blood pressure (P = .32), diastolic pressure (P = .73), and cortisol (P =.81). Blood pressure reactivity of the FHH group was significantly different than the no family history group (P = .0338). Cortisol levels for the total group were markedly elevated (19 nmol/dL) and there was no significant difference in reactivity., Conclusion: African American adolescents with FHH demonstrate increased blood pressure reactivity. Cortisol levels were elevated for all participants. This study adds support to the association of blood pressure reactivity, a biologic marker of HTN and FHH.

Atherogenesis is a complex process involving inflammation. S100A8 and S100A9, the Ca2+-binding neutrophil cytosolic proteins, are associated with innate immunity and regulate processes leading to leukocyte adhesion and transmigration. In neutrophils and monocytes the S100A8-S100A9 complex regulates phosphorylation, NADPH-oxidase activity, and fatty acid transport. The proteins have anti-microbial properties, and S100A8 may play a role in oxidant defense in inflammation. Murine S100A8 is regulated by inflammatory mediators and recruits macrophages with a proatherogenic phenotype. S100A9 but not S100A8 was found in macrophages in ApoE-/- murine atherosclerotic lesions, whereas both proteins are expressed in human giant cell arteritis. Here we demonstrate S100A8 and S100A9 protein and mRNA in macrophages, foam cells, and neovessels in human atheroma. Monomeric and complexed forms were detected in plaque extracts. S100A9 was strongly expressed in calcifying areas and the surrounding extracellular matrix. Vascular matrix vesicles contain high levels of Ca2+-binding proteins and phospholipids that regulate calcification. Matrix vesicles characterized by electron microscopy, x-ray microanalysis, nucleoside triphosphate pyrophosphohydrolase assay and cholesterol/phospholipid analysis contained predominantly S100A9. We propose that S100A9 associated with lipid structures in matrix vesicles may influence phospholipid-Ca2+ binding properties to promote dystrophic calcification. S100A8 and S100A9 were more sensitive to hypochlorite oxidation than albumin or low density lipoprotein and immunoaffinity confirmed S100A8-S100A9 complexes; some were resistant to reduction, suggesting that hypochlorite may contribute to protein cross-linking. S100A8 and S100A9 in atherosclerotic plaque and calcifying matrix vesicles may significantly influence redox- and Ca2+-dependent processes during atherogenesis and its chronic complications, particularly dystrophic calcification.

A mild and general route for preparing pyridines from nitriles and diynes is described. Ni/imidazolyidene complexes were used to mediate cyclization alkynes and both aryl and alkyl nitriles at ambient temperature. In addition, the efficacy of this protocol allows for the preparation of a fused seven-membered pyridone and for intermolecular cyclizations. When an asymmetrical diyne was employed, cyclization afforded a single pyridine regioisomer.

The bleomycins (BLMs) are structurally related glycopeptide antibiotics isolated from Streptomyces verticillus that mediate the sequence-selective oxidative damage of DNA and RNA. Deglycobleomycin, which lacks the carbohydrate moiety, cleaves DNA analogously to bleomycin itself, albeit less potently, and has been used successfully for analyzing the functional domains of bleomycin. Although structural modifications to bleomycin and deglycobleomycin have been reported, no bleomycin or deglycobleomycin analogue having enhanced DNA cleavage activity has yet been described. The successful synthesis of a deglycobleomycin on a solid support has permitted the facile solid-phase synthesis of 108 unique deglycobleomycin analogues through parallel solid-phase synthesis. Each of the deglycobleomycin analogues was synthesized efficiently; the purity of each crude product was greater than 60%, as determined by HPLC integration. The solid-phase synthesis of the deglycobleomycin library provided near-milligram to milligram quantities of each deglycobleomycin, thereby permitting characterization by (1)H NMR and high-resolution mass spectrometry. Each analogue demonstrated supercoiled plasmid DNA relaxation above background cleavage; the library included two analogues that mediated plasmid relaxation to a greater extent than the parent deglycobleomycin molecule.

The bleomycin (BLM) group of antitumor antibiotics effects DNA cleavage in a sequence-selective manner. Previous studies have indicated that the metal-binding and bithiazole moieties of BLM are both involved in the binding of BLM to DNA. The metal-binding domain is normally the predominant structural element in determining the sequence selectivity of DNA binding, but it has been shown that replacement of the bithiazole moiety with a strong DNA binder can alter the sequence selectivity of DNA binding and cleavage. To further explore the mechanism by which BLM and DNA interact, a trithiazole-containing deglycoBLM analogue was synthesized and tested for its ability to relax supercoiled DNA and cleave linear duplex DNA in a sequence-selective fashion. Also studied was cleavage of a novel RNA substrate. Solid-phase synthesis of the trithiazole deglycoBLM A(5) analogue was achieved using a TentaGel resin containing a Dde linker and elaborated from five key intermediates. The ability of the resulting BLM analogue to relax supercoiled DNA was largely unaffected by introduction of the additional thiazole moiety. Remarkably, while no new sites of DNA cleavage were observed for this analogue, there was a strong preference for cleavage at two 5'-GT-3' sites when a 5'-(32)P end-labeled DNA duplex was used as a substrate. The alteration of sequence selectivity of cleavage was accompanied by some decrease in the potency of DNA cleavage, albeit without a dramatic diminution. In common with BLM, the trithiazole analogue of deglycoBLM A(5) effected both hydrolytic cleavage of RNA in the absence of added metal ion and oxidative cleavage in the presence of Fe(2+) and O(2). In comparison with BLM A(5), the relative efficiencies of hydrolytic cleavage at individual sites were altered.

The N-succinyl-LL-diaminopimelate desuccinylase gene (dapE) in the four-step succinylase branch of the L-lysine biosynthetic pathway of Corynebacterium glutamicum was disrupted via marker-exchange mutagenesis to create a mutant strain that uses only the one-step meso-diaminopimelate dehydrogenase branch to overproduce lysine. This mutant strain grew and utilized glucose from minimal medium at the same rate as the parental strain. In addition, the dapE- strain produced lysine at the same rate as its parent strain. Transformation of the parental and dapE- strains with the amplified meso-diaminopimelate dehydrogenase gene (ddh) on a plasmid did not affect lysine production in either strain, despite an eightfold amplification of the activity of the enzyme. These results indicate that the four-step succinylase pathway is dispensable for lysine overproduction in shake-flask culture. In addition, the one-step meso-diaminopimelate dehydrogenase pathway does not limit lysine flux in Corynebacterium under these conditions.

Much recent research on acoustic cues for consonants' places of articulation has focused upon the nature of the rapid spectral changes that take place between signal portions corresponding to consonantal closure and adjacent vowels. The study reported here builds on the foundation laid by earlier studies that have explored techniques for representing spectral change and for classifying place of articulation of nasal consonants using features extracted from rapid spectral changes that take place over murmur-to-vowel transitions. A new procedure is reported that avoids the use of predetermined absolute frequency bands in deriving parameters of spectral change in nasals. In experiments using the speech of 20 female and 20 male talkers, in a variety of physical and perceptual spectral scalings, application of the new procedure results in 77% correct classification of place of articulation of syllable-initial nasals and 51% correct classification of place of articulation of syllable-final nasals (for which there is a three-way contrast). Tested on the same data, a technique using predetermined absolute frequency bands produced 72% correct classification of syllable-initial nasals.

This article is a lucid account of the mission and activities of the National Transportation Safety Board. The concept of the Go-Team or ready team of specialists available on a 3-hour basis to accident scenes is described, as is the Human Factors Investigation. General aviation accident investigations are also discussed.

The statutory authority and responsibility of the National Transportation Safety Board in the investigation and determination of the probable cause of aviation accidents is described. The Independent Safety Board Act of 1974 acknowledges the importance of obtaining data regarding trauma sustained in an accident by survivors, as well as those persons injured fatally. Information regarding occupant injuries, coupled with extensive examination of the aircraft wreckage, is necessary in order to identify hazards which inflicted the injuries. The human factors investigator is responsible for reporting the facts, conditions, and circumstances relating to first, the accident causation and, second, the injury causation. These two areas, of necessity, rely quite heavily upon the postmortem examination and laboratory analyses of the cras victims. The Safety Board's investigation must determine if a crewmember suffered from a preexisting disease, whether the crew had ingested drugs contraindicated with their flying duties, as well as a description of all injuries and all toxicological and histological findings for crew and passengers. During Safety Board investigations conducted in densely populated cites, over oceans, and in remote areas, both in the United States and overseas, many situations have developed which have caused musch investigative effort due to less than complete postmortem examinations. These situations, in most instances, could have been averted by advance planning by local authorities.